Paper published in the BMJ: Long term effect of reduced pack sizes of paracetamol on poisoning deaths and liver transplant activity in England and Wales: interrupted time series analysis
BMJ 2013;346:f403; K Hawton et al

PIC Response: This paper discusses the possibility that a reduction in paracetamol deaths from overdoses since 1989 is due to the legislation in that year restricting pack sizes for both OTC and Pharmacy sales.

However, although the reduced pack sizes must certainly have played some part, there are likely to be multiple causes of the reduction in deaths.

The authors suggest that further measures to restrict paracetamol availability might be worth researching, but a balance is necessary between providing adequate pain relief and protecting a vulnerable minority. Reduction in tablet content would almost certainly lead to loss in efficacy, and a further reduction in pack sizes would be impractical.

Paracetamol remains a very safe medicine when used at the correct dosage, and provides useful relief to millions of people suffering from mild to moderate pain and fever.